Walsh James R, Morris Norman R, McKeough Zoe J, Yerkovich Stephanie T, Paratz Jenny D
Queensland Lung Transplant Service, The Prince Charles Hospital, Rode Road, Chermside, QLD 4032, Australia ; School of Medicine, The University of Queensland, St Lucia, QLD 4072, Australia ; Physiotherapy Department, The Prince Charles Hospital, Rode Road, Chermside, QLD 4032, Australia.
Queensland Lung Transplant Service, The Prince Charles Hospital, Rode Road, Chermside, QLD 4032, Australia ; School of Rehabilitation Sciences and Griffith Health Institute, Griffith University, Parklands Drive, Southport, QLD 4215, Australia.
Pulm Med. 2014;2014:782702. doi: 10.1155/2014/782702. Epub 2014 Jan 30.
The aim was to determine if baseline measures can predict response to pulmonary rehabilitation in terms of six-minute walk distance (6MWD) or quality of life. Participants with COPD who attended pulmonary rehabilitation between 2010 and 2012 were recruited. Baseline measures evaluated included physical activity, quadriceps strength, comorbidities, inflammatory markers, and self-efficacy. Participants were classified as a responder with improvement in 6MWD (criteria of ≥25 m or ≥2SD) and Chronic Respiratory Questionnaire (CRQ; ≥0.5 points/question). Eighty-five participants with a mean (SD) age of 67(9) years and a mean forced expiratory volume in one second of 55(22)% were studied. Forty-nine and 19 participants were responders when using the 6MWD criteria of ≥25 m and ≥61.9 m, respectively, with forty-four participants improving in CRQ. In a regression model, responders in 6MWD (≥25 m criteria) had lower baseline quadriceps strength (P = 0.028) and higher baseline self-efficacy scores (P = 0.045). Independent predictors of 6MWD response (≥61.9 m criteria) were participants with metabolic disease (P = 0.007) and lower baseline quadriceps strength (P = 0.016). Lower baseline CRQ was the only independent predictor of CRQ response. A participant with relatively lower baseline quadriceps strength was the strongest independent predictor of 6MWD response. Metabolic disease may predict 6MWD response, but predictors of CRQ response remain unclear.
目的是确定基线测量指标能否在六分钟步行距离（6MWD）或生活质量方面预测肺康复的反应。招募了2010年至2012年间参加肺康复的慢性阻塞性肺疾病（COPD）患者。评估的基线测量指标包括身体活动、股四头肌力量、合并症、炎症标志物和自我效能感。参与者若6MWD改善（标准为≥25 m或≥2标准差）且慢性呼吸问卷（CRQ；≥0.5分/题）得分提高，则被分类为反应者。研究了85名平均（标准差）年龄为67（9）岁、一秒用力呼气量平均为55（22）%的参与者。分别采用≥25 m和≥61.9 m的6MWD标准时，49名和19名参与者为反应者，44名参与者的CRQ得分有所提高。在回归模型中，6MWD（≥25 m标准）的反应者基线股四头肌力量较低（P = 0.028），基线自我效能感得分较高（P = 0.045）。6MWD反应（≥61.9 m标准）的独立预测因素是患有代谢疾病的参与者（P = 0.007）和较低的基线股四头肌力量（P = 0.016）。较低的基线CRQ是CRQ反应的唯一独立预测因素。基线股四头肌力量相对较低的参与者是6MWD反应最强的独立预测因素。代谢疾病可能预测6MWD反应，但CRQ反应的预测因素仍不清楚。
